Prior research had examined the persistence of child and adolescent psychiatric disorders in both representative community and pediatric samples indicating fairly consistent persistence rates for externalizing disorders, as well as internalizing disorders. This study focused on data from a 1 year follow-up of a representative pediatric sample of children whose psychiatric diagnostic status was first assessed at ages 4 to 9. In addition, patterns of persistence are examined overall and for boys and girls separately. Persistence were examined by type of disorder which included internalizing versus externalizing, full versus subthreshold, severity, and impairment. Lastly, the multivariable contributions of sociodemographic, parent, and family factors and initial diagnostic presentation to persistence were examined. From a representative sample of pediatric primary care practices, 996 children ranging from age 4 to 9 participated in a 1 year follow-up in 1989-1990. Study findings suggest substantial diagnostic persistence with 44 percent of boys and 29 percent of girls with any initial disorder continuing to have full disorder 1 year later. Approximately one in four children with initial subthreshold disorders only continued to have subthreshold disorders at follow-up. The results suggest that subthreshold disorders deserve further research. In addition, results of multivariable analyses indicated greater persistence among children with high levels of symptoms in general, suggesting that psychopathology that is more severe and/or pervasive is likely to persist over time. Study limitations and implications are presented and discussed. Tables and references